胆囊结石患者腹腔镜胆囊切除术后对肝功能和免疫应激的影响分析

Analysis of Influence of Liver Function and Immune Stress After Laparoscopic Cholecystectomy in Patients with Cholecystolithiasis

目的探究腹腔镜胆囊切除术(LC)治疗胆囊结石的疗效及其对肝功能和免疫应激的影响。方法 74例胆囊结石患者均为广州新海医院2014年5月—2018年5月间收治,随机分两组,各37例,观察组采用LC治疗,对照组采用开腹胆囊切除术(OC)治疗,对比两组术后肝功能、免疫应激等指标的变化。结果观察组的术中出血量显著少于对照组,手术时间、术后排气时间及住院时间显著短于对照组;术后5 d,观察组的血清ALT、AST及TBIL水平,血糖、肾上腺素及CRP水平与CD3+、CD4+水平均显著低于对照组,CD8+水平显著高于对照组,且观察组更接近于术前水平;术后,观察组的并发症发生率显著低于对照组。结论 LC治疗胆囊结石安全、有效,能有效抑制应激反应,减轻对机体肝功能及免疫功能的影响,患者术后恢复快,故推荐使用。

Objective To explore the clinical effects of laparoscopic cholecystectomy(LC)in treatment of cholecystolithiasis and its influence of liver function and immune stress.Methods74patients with cholecystolithiasis treated in the hospital from May,2014to May,2018were randomly divided into two groups,with37cases in each group.The observation group were treated with LC,while the control group were treated with open cholecystectomy(OC).Then,the changes of liver function and immune stress after operation were compared between the two groups.Results The amount of intraoperative bleeding in the observation group was significantly less than that in the control group,and the operation time,postoperative exhaust time and hospitalization time were significantly shorter than those in the control group.5days after operation,the levels of serum ALT,AST and TBIL,BG,epinephrine and CRP levels,and the CD3+and CD4+levels in the observation group were significantly lower than those in the control group.The level of CD8+was significantly higher than that in the control group,and the observation group was closer to the preoperative level.After operation,the incidence of complications in the observation group was significantly lower than that in the control group.Conclusion LC in treatment of cholecystolithiasis is safe and effective,and can effectively inhibit the stress reaction,reduce the influence on the liver function and immune function.And patients recover quickly after the operation.Therefore,it is recommended to be used.